Manager to Leader: Seven Transitional Steps

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In a landscape growing increasingly concerned with cost, quality, and results, strong leaders are needed to pave a path for the future of health care. Conventional wisdom dictates that leaders are born from a mix of experience and acquired skills. Given these requirements, managers are natural candidates, but not every manager has what it takes to become a leader.

Managers with all the experience in the world can stumble when faced with the heavy task of leading an entire organization. In the June 2012 issue of Harvard Business Review, Watkins¹ explains why some managers succeed in becoming leaders—and why some fail to make that transition.

To find the secret behind successful leadership, Watkins conducted extensive interviews with more than 40 executives, including managers who had developed high-potential talent, senior human-resources professionals, and individuals who had moved into an enterprise-level leadership position for the first time.

The scope and complexity of leadership can be daunting, leaving freshly appointed executives feeling overwhelmed and uncertain. To cope with these changes, Watkins finds, executives must undergo seven shifts—tricky changes in their mental focus that require them to develop new skills and conceptual frameworks—to become true leaders.

Specialist to generalist: There is danger for leaders who excel at a particular function, especially in the medical field, where one can easily become overspecialized. New leaders can fall into the trap of their comfort zones, overmanaging the one function that they know well while neglecting the others. Leaders cannot be specialists; they must become generalists and must recognize the organization as a set of functions (each with its own unique operational templates). Billing personnel have different responsibilities to the organization than do radiologists, technologists, and support staff. Leaders must see each department as one piece of the whole.

Analyst to integrator: Decisions can no longer be made in a vacuum, in consideration of a single function; they have to be made in conjunction with information acquired from different—and sometimes, competing—departments. Concerns from different sectors of the organization have to be balanced. Should investment go into equipment, staffing, or programs? By using the collective knowledge of different functions, leaders can make appropriate trade-offs to solve complex organizational problems.

Tactician to strategist: Being tactical is seductive, since the activities are more concrete and the results are so immediate, Watkins writes. It becomes easy to get lost and bogged down in the small details. Executives at the enterprise level need to focus on strategic objectives and leave tactical operations to other managers. This is difficult for newcomers, since setting strategy requires navigation of murky terrain. Three skills are needed to develop a strategic mindset: level shifting, pattern recognition, and mental simulation. Level shifting is the ability to move fluidly between the details and the larger picture, pattern recognition enables leaders to make sense of complex environments, and mental simulation considers the movement of external forces and players.

Bricklayer to architect: New leaders often attempt to make their marks by targeting elements of the organization that seem relatively easy to change, such as strategy or structure, without completely understanding the effects that their moves will have on the organization as a whole, Watkins writes. Making changes without understanding the ripple effects can lead to unexpected consequences. Great leaders can analyze and design organizational systems so that strategies, structures, operating models, and skill bases fit together effectively and efficiently.

Problem solver to agenda setter: Many managers are promoted on the strength of the ability to fix problems. When they become enterprise leaders, however, they must focus less on solving problems and more on defining which problems the organization should be tackling. The goals are not to correct current problems, but to anticipate future problems and to take steps to address them before they become harder to manage.

Warrior to diplomat: Health care is inextricably tied to a multitude of governing bodies, advocate groups, and regulatory organizations, each of which holds a different stake and sets a different agenda. A leader must be prepared to jump into this volatile environment and